AST-0086-2018 i
I
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
- Community Development-Building& Codes (518) 761-8256
C ERTIFICATE OF OMPL,IANE
Permit Number: AST-0086-2018 Date Issued: Thursday, June 28, 2018
This is to certify that work requested to be done as shown by Permit Number AST-0086-2018
has been completed.
Tax Map Number: 308.6-1-67
Location: 34 WARREN LN
Owner: Michael LeBlanc
Applicant: Michael LeBlanc
I
This structure may be occupied as a: Detached Garage 560 sq. ft.
Cross Ref. Z-AV-4-2018 Approved 1/24/2018 By order of Town Board
TOWN OF QUEENSBURY
(7Issuance of this Certificate of Compliance DOES NOT relieve the /
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues'and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
r
-- TOWN OF QUEENSBURY
742 Bay Road, Queensbury,NY 12804-5904 (518)761-8201
y Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: AST-0086-2018
Tax Map No: 308.6-1-67
Permission is hereby granted to: Michael LeBlanc
For property located at: 34 WARREN LN
In the Town of Queensbury,to construct or place at the above location in accordance with application together
with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Type of Construction
Owner Name: Michael LeBlanc Detached Garage $8,500.00
Owner Address: 34 Warren LN Total Value $8,500.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Peter Jensen
17 West ST
Glens Falls,NY 12801
Plans&Specifications
Detached Garage 560 sq. ft.
Cross Ref. Z-AV-4-2018 Approved 1/24/2018
$ 175.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday,March 13,2019
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town ue bury; 4 Tu 13,2018
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
Office Use Oniv
'4 ACCESSORY STRUCTURE Permit#:
PERMIT APPLICATION Permit Fee: $
Town of Queensbury
742 Bay Road,Queensbury,NY 12804 Invoice#: iL�5
P:51B-761-8256 www.gueensburV.net
Project Location. 3i-( WA&RtI-� LArat
Tax Map I® #: 3oy. - I - Subdivision Name: f4A
CONTACT INFORMATION:
® Applicant: � MAR Q 5 20i�
Name(s): n,-' ckr_ e- ( LetJ L
Mailing Address, C/S/Z: t3 q 0 AK2R Lai1e
Cell Phone: (519 ) �iS I (of/ Land Line:
i RY
-NT
Email: nC; j 6 C? "nai C(kn
• Primary Owner(s):
Name(s): 5 An1 e-
Mailing Address, C/S/Z:
Cell Phone: �_) Land Line: � )
Email:
• Contractor(s):
Business Name: SA/h e- 0
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: �_} Land Line:
Email:
® Architect(s)/Engi nee r(s):
Business Name: ���
Contact Name(s):
Mailing Address, C/S/Z: /'� pr�d: e
Cell Phone: Land Line:
Email:
Contact Person for Building & Code Compliance:
Cell Phone: A ) Land Line:
Email:
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
PROJECT INFORMATION:
b.
TYPE: Commercial ,` Residential
WORK CLASS:
_Deck, Open Porch _Solar Panels(w/o rafter upgrades) _Carport _Cell Tower
_Shed _Pavilion, Pole Barn,Canopy _Dock _Gazebo
Detached Garage _Boathouse(with or w/o sundeck) _3-Season Porch
_Other(description: )
SQUARE FOOTAGE OF STRUCTURE:
t ,
1st floor: b X 7 J
2"a floor:
Total square feet:_
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ 9=QED' 9 .
2. If Commercial project,what is the proposed use:
3. Are there any structures not shown on the plot plan? YES NO Explain:
4. Are there any easements on the property? YES NO
DECLARATION:
1. I acknowledge that no construction shall be commenced prior to issuance of a valid permit and will be
completed within a 12 month period.
2. Ifthework is not completed by the 1 year expiration date the permit may be renewed, subject to fees
and department approval.
3. 1 certify that the application, plans and supporting materials are a true and complete statement and/or
description of the work proposed, that all work will be performed in accordance with the NYS Building Codes, local
building laws and ordinances, and in conformance with local zoning regulations.
4. 1 acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
5. 1 also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above:
PRINT NAME: it 1 , Ckae LE' ,� ia-,)c
SIGNATURE: DATE: `
Town of Queensbury Building&Code Enforcement Accessory Structure Application Revised April 2017
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s ` r, 308.6-1-67 AST-0086-2018
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34 Warren
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*} BUILDING DEPARTMENT NEW YORK 12103S"
i S CAL. w t L t? ° _
Bawitc on our mite compliance Pi 120,1
limited exa amination,co e {518)798-3858
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NOW OR FORMERLY NOW OR FORMERLY NOW OR FORMEFLY NOW OR FORMERLY NOW OR FORMERLY
LANDS OF I LANDS OF LANDS OF LANDS OF LANDS OF
DANIEL WOOD 1 �Ttty WASHBURN AND TINA WASHBURN ( ROBERT PARIS GEORGE WARD I WILLIAM E. MANNEY I
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GIBER 535, PAGE 76. M "> tY� 1v >` ___-- _ I zD' to
¢ zo' t_� MICHAEL LeBLANC & DANIEL SWEET I
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HENRY& PATRICIAPAIRICIA SIEVES
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I LANDS OF I PROPOSED Sl RUCTURE(S)OR SIGN(S) Q o
AL Will.F- DEAN, Sr. & MARY LOU CENTER6AR MAP REFERENCES LANDS OF 7 J//� � ���`�� W Z o o
DOUGLAS & WENDY VANCE /� ��,7c T� �lc/�_ / u � 4 o w to
LIBER 1005 PAGE 114 1) MAP ENTITLED. "MAP OF A SURVEY OF LANDS LIBER 691, PAGE 925 SIGNATURE DATE U o ^a
TAX MAP: 308.06-1-77 TO BE CONVEYED TO MICHAEL do KAREN LeBLANC" TAX Al• 308.06-1-79 MAP REVISION # '1' LU 3 I a
DATED JULY 12, 1999, PREPARED BY DAVID J. BOLSTER, �'p � �x
LICENSED LAND SURVEYOR. DECEMBER 7, 2017 TO SHOW PROPOSED GARAGE D �--� < '
ON LOT 1, LANDS OF MICHAEL & KAREN LeBLANC.
2) MAP ENTITLED: "MAP OF LANDS OF MICHAEL & KAREN MAR 0 5 1018
LeBLANC". DATED AUGUST 1, 2017, PREPARED BY
DEED REFERENCE W.J. ROURKE ASSOCIATE LICENSED LAND SURVEYORS, _
�T WN Cox- 01jE!:t�`��U2Y
JANE9 CONNE LY and 3)MAP ENTITLED: "MAP OF A SURVEY OF LANDS OF b1' � ,,, SURVEY MAP A4 1�i1
JoANN CONNF_ SAMUEL J. WAHNON, Jr. AND VIOLA WAHNON" DATED - ^ p BY ``A JW,0`�O`'�'.�3t�YBE711V�q/ON
n s .. T'
i_�"Y NOVEMBER 11,. 2009, LAST REVISED AUGUST 17, 2010, � -
To {. r= DLP SURVEYING, LLC
308.6-1-67 AST-0086-201 H PREPARED BY DLP SURVEYING, LLC. LANDS OF
MICHAEL LeBLANC and �'' �x DONALD L. PIDGEON,Jr.
Michael KAREN LeBLANC q:6
LeBlanc, i.`. PROFESSIONAL LAND SURVEYOR MICHAEL LeBLANC AND KAREN LeBLANC
DT
34
271 1s9s A a .;�II m 6
TAX MAP REFERENCE t I p I N.Y.S. LICENSE NO. 50372
34 Warren Lane RC?. JULY 271 1999 � f iq ^ SITUATED IN
Detached Garage 560 s.f. LIBER 1124, Pl288 SECTION 308.06, BLOCK 1, PARCEL 67 1 :„ s,e24 1` ` 16 MICHAEL ROAD TOWN OF QUEENSBURY, WARREN COUNTY, NEW YORK
FORT EDWARD, NEW YORK 12828
518-792-4146 SCALE: 1" = 50' ! � SEPTEMBER 21, 2017
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